Dr. Nina Olsen shares questions to discuss with your doctor at a preconception visit to get you closer to your goal of a healthy pregnancy.
You’re thinking about getting pregnant – how exciting! We know you’ll have a lot of questions as you begin this new journey. Before you start trying to conceive is the perfect time to schedule a preconception visit so that you and your doctor can discuss how to have the best chance for a successful, healthy pregnancy. To help you make this a productive conversation, I’ve put together a list of questions to ask at a preconception visit. There’s a lot to learn so you’ll want to come ready to take notes!
1. When should I stop using birth control?
First things first, you’ll need to go off birth control to become pregnant. Different methods of contraception affect your cycle in different ways. With some methods, you can stop using it at any time and be able to become pregnant the very next cycle. Other methods may have a delay in the return to fertility. For example, Depo Provera has a known effect of delayed fertility of up to 12 months after the last injection. Your doctor can advise you on when to stop birth control so that you can plan your pregnancy better.
2. When am I most fertile during my menstrual cycle?
While most women will ovulate around day 14 of their cycle, this timing can vary depending on your cycle length. Therefore, it’s important to discuss with your provider how to track your cycle and use ovulation predictor kits to better estimate your fertile window. They can teach you how to time intercourse during that window to optimize your chances of conceiving.
3. When should I start taking prenatal vitamins?
This is a very important question, so I’ll go ahead and answer it! It is recommended to take a prenatal vitamin with folic acid for at least 3 months prior to conception as they are shown to prevent fetal malformations. Prenatals will also help with nausea and vomiting once you become pregnant.
You’ll want to talk to your doctor about your diet and what nutrients you might need to supplement with prenatal vitamins. Check out Dr. Dogal’s blog post, Everything You Need to Know about Prenatal Vitamins (Whether You’re Pregnant or Not), to learn more.
4. Do I need to adjust any of my medications?
It is extremely important to discuss with your doctor all of the medications that you are currently taking as some of them can be harmful to pregnancy. Given that you likely will not know about your pregnancy for at least 2 weeks after conception, you may inadvertently be taking medications that are harmful to the baby.
5. How will my health affect my pregnancy pursuit?
Ideally, you need to be in the best health possible to achieve and safely carry the pregnancy. Discuss any chronic medical conditions with your provider and work with them on optimizing your health.
6. How will my partner’s health affect our pregnancy pursuit?
Certain medical conditions may make your partner infertile or subfertile. Therefore, it’s important to discuss your partner’s health with your provider as well.
7. How will my partner’s and my family history affect our pregnancy pursuit?
It is important for your provider to know your partner’s and your family history as certain conditions such as recurrent pregnancy loss or infertility may have genetic predisposition. If your provider knows that ahead of time, they can make better recommendations.
8. Are there any lifestyle changes I’ll need to make?
It is very important to discuss with your provider your current lifestyle and get advice on things to avoid or limit such as caffeine, alcohol, tobacco and drug use. You might also discuss exercise, nutrition, stress management, and sleep. Check out Dr. Pound’s tips for mind and body prep to learn more.
9. Do we need to undergo any fertility testing?
In general, if you have regular periods and are in good health overall, no fertility testing is needed prior to trying to conceive. We just say “Go for it!” However, if your periods are irregular or there are other red flags in your history which may make you infertile, it is important to discuss these concerns with your provider at the preconception visit.
10. Is there anything I should do differently due to my age?
Fertility does diminish with age, and it decreases significantly after age 42. If you are 35 or older and trying to conceive, we recommend evaluation for infertility earlier than we do for younger women. As time is of the essence at this age, a preconception visit is important for getting off to a strong start on your journey towards pregnancy.
Check out Dr. Brim’s blog post, Getting Pregnant at 40: FAQ’s and Tips for Optimizing Your Fertility Health, to learn more.
11. Do we need to undergo genetic testing?
There are certain genetic disorders that are rare but can be devastating, such as cystic fibrosis, spinal muscular atrophy or Fragile X Syndrome. Ideally, testing for genetic mutations causing these diseases should be performed prior to pregnancy. Learn more in Dr. Neuman’s blog post, Preconception Genetic Testing 101: A Complete Guide.
12. Will a miscarriage affect my chances of becoming pregnant?
It is very common to have one miscarriage and it should not affect your chances of becoming pregnant or carrying a pregnancy to term. However, it is less common to have two or more miscarriages in a row. If you have suffered through multiple miscarriages, it’s important to discuss this with your provider.
13. Are there any other ways I can optimize my chances of getting pregnant?
This is a great question to ask at the end of your visit in case there’s anything you and your doctor haven’t discussed that might be helpful. You might discuss fertility-friendly lubricants (different lubricants have different effects on sperm motility and vitality!), cycle and ovulation tracking apps, etc. When it comes to fertility, there are so many factors at play, and we encourage you to have an open conversation with us so that we can help you achieve your goal of becoming pregnant.
14. When is it time to see a specialist?
What if you’ve already asked all the questions and followed the recommendations, but still have not been able to conceive? If you are under 35 years old, we would recommend either seeing your primary OB/GYN or an infertility doctor if there is no conception after 12 months of regular unprotected intercourse. If you are older than 35, an infertility workup is recommended after 6 months of unprotected intercourse without conception.
If your periods are very irregular or non-existent, or if you have other red flags in your history that are commonly associated with infertility (for example, history of sexually transmitted diseases, painful periods and intercourse), you may want to seek a consultation with a specialist sooner.
Getting the most out of your preconception visit
Once you and your partner decide you’re ready to grow your family, it’s so important to be proactive about your fertility health. The journey to pregnancy is not one-size-fits-all, and my colleagues and I look forward to providing each patient with personalized preconception counseling and care. It all starts with asking the right questions to help give us a complete picture of your health.